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오명돈 ( Myoung Don Oh ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5
Human immunodeficiency virus (HIV) infection can produce profound defects in cell-mediated immunity, and HIV-infected patients have a markedly increased incidence of malignancies. Kaposi`s sarcoma was the first malignancy to be recognized as a cancer defining acquired immunodeficiency syndrome (AIDS). Non-Hodgkin`s lymphoma is also associated with AIDS. HIV-infected patients are also at increased risk of developing cancers related to human papilloma virus, such as cervical cancer and anal cancer. As the life expectancy of HIV-infected patients has increased dramatically with advances in anti-retroviral therapy, the screening and prevention of malignancies should be included in the management of HIV-infected individuals. (Korean J Med 76:551-553, 2009)
치료를 받은 적이 없는 HIV 환자에서 항HIV 약제 내성
오명돈 ( Myoung Don Oh ) 대한내과학회 2007 대한내과학회지 Vol.73 No.3
Antiretroviral therapy for treatment of human immunodeficiency virus type 1 (HIV-1) infection has improved steadily since the introduction of combination therapy in 1996. With the advancement of antiretroviral therapy, the mortality of AIDS patients has markedly improved. However, drug resistance has been emerging as a major problem in HIV treatment. Several studies reported that the prevalence of transmitted resistant virus involving antiretroviral-naive people in developed countries was around 10%. Primary drug resistance is rare in HIV-1 infected patients in Korea. A cohort study is need to monitor resistant HIV-1 among newly infected individuals.(Korean J Med 73:235-236, 2007)
전신성 홍반성 낭창 환자에서 발생한 Mycobacterium abscessus에 의한 폐렴
임재준 ( Jae Joon Yim ),오명돈 ( Myoung Don Oh ),유철규 ( Chul Gyu Yoo ),송영욱 ( Yeong Wook Song ),김영환 ( Young Whan Kim ),서정욱 ( Jung Wook Seo ),한성구 ( Sung Gu Han ),최강원 ( Kang Won Choe ),심영수 ( Young Soo Shim ) 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.1
급성 관동맥증후군과 만성 안정형협심증 사이에서 보이는 전환효소와 안지오텐시노젠 유전자 다형성의 차이
이명묵(Myung Mook Lee),오명돈(Myoung Don Oh),최강원(Kang Won Choi),오병희(Byung Hee Oh),김효수(Hyo Soo Kim),김광일(Kwang Il Kim),채인호(In Ho Chae),손대원(Dae Won Sohn),박영배(Young Bae Park),최윤식(Yun Shik Choi),이영우(Young Woo Le 대한내과학회 1999 대한내과학회지 Vol.56 No.5
N/A Objectives : The renin-angiotensin system(RAS) had an important role in the pathogenesis of ischemic heart disease(IHD). Angiotensinogen(ATG), angiotensin-converting enzyme(ACE), and angiotensin II receptor are key components of RAS and reported to have polymorphisms. We studied to investigate the separate and interactive effects of ACE (I/D) and ATG (M235T) gene polymorphisms on the pathogenesis of IHD, and to compare the genetic influences between on the chronic stable angina(CSA) and on the acute coronary syndrome(ACS). Methods : We studied total 468 patients who underwent CAG. Control group comprised 159 patients who did not have a significant coronary lesion. IHD group was subgrouped according to clinical manifestation into CSA group(n=90) and ACS group(n=219). To determine the frequency of ACE and ATG genotype, polymerase chain reaction (PCR) and enzyme digestion was done. Results : 1) In ACS group, genotype frequency of ACE(II:ID:DD) was 0.27:0.48:0.25 and ATG (MM:MT:TT) was 0.31:0.59:0.10, which was significantly different from control group (ACE II:ID:DD =0.38:0.45:0.17 and ATG MM:MT:TT =0.51:0.40:0.09) (p<0.05). 2) There was no significant difference in genotype frequency of ACE, ATG gene between CSA group and control. 3) In multiple logistic regression analysis, sex, age, ATG and ACE genotype were independent risk factors for ACS. The relative risk for ACS in ACE DD compared to II genotype was 3.52 (95% CI: 1.52-8.13) and that in ACE ID compared to ACE II genotype was 1.55 (95% CI: 0.82-2.94), which showed that the risk increased with the number of ACE D-allele. In contrast, sex, age, and DM were independent risk factors for CSA, whereas ATG and ACE genotype were not. 4) In combined analysis including both ACE and ATG gene polymorphism, the relative risk for ACS associated with ATG genotype increased with the number of ACE D-allele. Conclusion : ACE and ATG gene polymorphism are associated with the development of ACS but not CSA, which suggests that ACE and ATG genes may be involved in the plaque unstabilization or thrombosis rather than the chronic progression of coronary atherosclerosis.
인간 면역부전바이러스 ( Human Immunodeficiency Virus ) 에 감염된 우리 나라 환자 35 명의 기회 감염증
최강원(Kang Won Choe),오명돈(Myoung Don Oh),김성민(Seong Min Kim),김남중(Nam Joong Kim) 대한내과학회 1995 대한내과학회지 Vol.48 No.5
N/A Objectives: The first AIDS case in Korea was reported in 1985. Since then the number of HIV/AIDS patients has increased steadly, As of end of 1993, a total of 323 HIV patients was reported. Incidence of several opportunistic infections(OI's) associated with HIV/AIDS appears to vary from country to country. To assess which are common OI's associated HIU/AIDS patients in Korea, we reviewed OI's in Korean HIV/AIDS patients. Methods: We reviewed retrospectively OI's in 35 HIV/AIDS patients who had been admitted or followed up for at least 6 months at the Seoul National University Hospital during the period of 1987 to June 1994. The diagnoses of OI's were made according to the CDC guidelines(MMWR 1992). CD4(+) lymphocytes count was calculated from total lymphocytes counts by percents of CD4(+) lymphocytes, which were measured by using immunofluorescent monoclonal antibody. Results: Tuberculosis(Tb) developed in 34%(12/35) of the patients. Of 12 patients with Tb, 5 had pulmonary Tb, 4 had pulmonary Tb with mediastinal lymph node involvement, 1 had cervical lymph node Tb, and 2 had miliary Tb. Candidoses developed in 23 % (8/35), pneumocystis carinii pneumonia in 20% (7/35), herpes zoster in 17% (6/35), CMV retinitis in 9% (3/35), and cryptococcal meningitis in 6% (2/35) of the patients. One of the patients had high antibody titer against toxoplasma. Median number of CD4(+) lymphocyte counts/mm3 at the time of the diagnoses of OI's was as follows: herpes zoster 242, Tb 137, cryptococcal meningitis 27, candidoses 23, P. carinii pneumonia 19, and CMV retinitis 11. OI's were clues to diagnoses of HIV infections in 20% (7/35) of the patients. OI's providing diagnostic clues to HIV infections were: P. carinii pneumonia in 2, Tb in 1, herpes zoster in 1, cryptococcal meningitis in 1, candidiasis in 1, and fever of unknown origin in l. Half(5/9) fatal cases died of pulmonary complications; 22% (2/9) of central nervous system infections; One patient committed suicide. Responses to treatment of Tb were good, and no patient died of tuberculosis. Conclusion: Tb was the most common OI in patients with HIV/AIDS. Considering very high prevalence of IgG CMV antibody in Korean population, CMV retinitis appears to be relatively uncommon. Toxoplasmosis was rare. Other OI's appear to be similar to that in other countries.
내과 임상실습에서 문제바탕학습 (Problem-based Learning)을 응용한 항생제 교육
박완범(Wan Beom Park),김홍빈(Hong Bin Kim),김남중(Nam Joong Kim),오명돈(Myoung -don Oh),최강원(Kang Won Choe),이윤성(Yoon Sung Lee),신좌섭(Jwa-Seop Shin) 한국의학교육학회 2007 Korean journal of medical education Vol.19 No.1
Purpose: The purpose of this study is to develop a course to teach through problem-based learning the use of antibiotics during an internal medicine clerkship, and to evaluate the responses of students to it. Methods: The course was designed to teach third-year medical students how to prescribe antibiotics to be given to real patients. A qualitative evaluation for the modified problem-based learning was performed by tutor’s observation and focus group interview, and a quantitative evaluation by questionnaires before and after the course. Results: Seventy-nine students experienced the modified problem-based learning during the infectious disease section of an internal medicine clerkship. Most students participated actively and gave a positive evaluation expressing a need for problem-based learning on prescribing antibiotics. The course significantly increased the students’ self-confidence in both approaching patients and prescribing antibiotics. Conclusion: Modified problem-based learning is a useful educational tool in clinical clerkship.
증례 : 수년에 걸쳐 진행한 폐결절을 가진 불명열 환자에서의 항암화학요법 1예
김유정 ( Yu Jung Kim ),김선영 ( Sun Young Kim ),오명돈 ( Myoung Don Oh ),유철규 ( Chul Gyu Yoo ),허대석 ( Dae Seog Heo ),김철우 ( Chul Woo Kim ),방영주 ( Yung Jue Bang ) 대한내과학회 2006 대한내과학회지 Vol.71 No.4
저자들은 수년에 걸쳐 진행한 폐결절을 가진 불명열 환자에서 조직학적으로 규명되지는 않았으나 EB 바이러스 관련 림프세포증식질환을 의심하여 항암화학요법을 시행한 후 관해를 이룬 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Classic causes of fever of unknown origin (FUO) are infections, neoplasms, collagen vascular diseases and drugs. However, large studies of FUO have consistently reported that a considerable proportion of patients with FUO remain undiagnosed. We report a patient with a prolonged course of FUO and progressive pulmonary nodules in whom extensive clinical and laboratory evaluation did not reveal specific diagnosis. The patient had recurrent episodes of fever for more than three years, and the pulmonary nodules gradually progressed in size and number despite administration of antibiotics including antifungal and antituberculosis agents. Several pathologic examinations demonstrated an organizing pneumonia or non-neoplastic lung parenchyma with lymphoplasmacytic infiltration only. After a protracted course of disease, we thought that this patient might have lymphoproliferative disorder, possibly EBV-associated, and started anti-cancer chemotherapy. He was successfully treated with eight cycles of chemotherapy including cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP).(Korean J Med 71:442-448, 2006)